ITN 10770 Exhibit3 SampleYouthDischargeForm.pdf

PDF 80 KB Posted

Attached to
PRE - CINS/FINS and Respite Services
Solicitation number
ITN-07405
Issued by
Leon County, Florida

About this file

This document is an Invitation to Negotiate (ITN) issued by the Florida Department of Juvenile Justice (DJJ) to select a lead agency to provide statewide Children in Need of Services/Families in Need of Services (CINS/FINS), Statewide Detention Respite Care Services, Probation Respite Bed Services, Respite Bed Services for Civil Citation Youth, and evidence-based or promising practices delinquency prevention programming. The selected lead agency will subcontract with local service providers to deliver these services throughout Florida's 20 judicial circuits for youth between the ages of 8 and 18. The services sought include residential and non-residential care, data collection and reporting, management, and coordination of the statewide service delivery network.

The DJJ is seeking proposals from community, faith-based, not-for-profit organizations, LLCs, and/or divisions of local government to serve as the lead agency. The ITN does not provide specific pricing terms, set-asides, or funding amounts. However, it does state that the lead agency will be responsible for contracting with local service providers and overseeing all components of training, service delivery, contract management, and operations.

View the file

Other files

File Type Posted
ITN 10770 Attachment T.docx DOCX document
ITN_10770_FinalAgencyDecision.pdf PDF
ITN 10770 Ex4 StartUpImplementationPlan.docx DOCX document
ITN 10770 Informational Notice 1.pdf PDF
ITN 10770 solicitation document.pdf PDF
ITN 10770 Ex7 ServiceUtilizationReport.xlsx XLSX spreadsheet
ITN_10770_Attachment_N.docx DOCX document
ITN 10770 Attachment J.xlsx XLSX spreadsheet
ITN 10770 Attachment Q.pdf PDF
ITN 10770 Attachment R.docx DOCX document
ITN 10770 Exhibit1 Invoice.pdf PDF
Show all 11

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

ITN #10770

EXHIBIT 3

SAMPLE YOUTH DISCHARGE FORM

Youth’s Name (First initial, Last name) _____________________________________________

JJIS Number ___________________________________________________________________

Admission Date_________________________________________________________________

Discharge Date_________________________________________________________________

Program Instructor’s Signature____________________________________________________

*If services are not rendered within a 30-day period, the youth will be released/discharged from the program.

A Youth Discharge form with a properly prepared invoice shall be submitted directly to the Department’s

Contract Manager within 15 business days following the end of the month for which services were rendered.

File details come from the government source that posted it. Updated .